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Southampton clinicians lead pioneering children's sleep project

Staff at Southampton Children’s Hospital are leading a pioneering project to improve the sleep environment for young patients and their parents.

The Southampton Sleep for Health in Hospital (SSHH!) programme, led by Dr Catherine Hill, a consultant in paediatric sleep medicine, and her team, is the first of its kind in the UK.

Through collaboration with parents and children, clinicians, management, hospital governors and estates personnel, the project aims to fundamentally change the ward culture to respect children’s sleep.

“Reducing noise at night is an NHS quality indicator but hospitals are notoriously poor sleep environments and many fail to accurately monitor or address this common source of complaint,” explained Dr Hill, who is also an associate professor of child health at the University of Southampton.

“Children may be anxious and in pain but face regular sleep disruption from noise, nursing and medical care and hospital routines and much of that is preventable.”

Ahead of the SSHH! programme, Dr Hill conducted a research study at Southampton Children’s Hospital which found that both children and their parents slept on average over an hour less in hospital compared to their normal night's sleep at home – largely due to noise.

Despite World Health Organisation recommendations of an average sound level of 30 decibels (dB) in hospitals at night – equivalent to a quiet conversation – Dr Hill’s research found the average level was much higher and, at times, peak levels were recorded equal to the sound of a vacuum cleaner.

‘’We all feel out of sorts after a bad night’s sleep but when children lose sleep in hospital they have a lower pain threshold, are more emotional and may have lowered immune defences – all compelling reasons why sleep should be protected,” said Dr Hill.

She said that while night standards do exist across University Hospital Southampton NHS Foundation Trust, which also runs Southampton General and the Princess Anne hospitals, they are geared towards adult patients with options such as decaffeinated bedtime drinks, ear plugs and eye shades.

“For children we needed some more imaginative approaches and, with the help of parents, children and staff, we have developed some simple, practical approaches to create a hospital environment that really respects children’s sleep,” she explained.

“The project will see the introduction of ‘eight is late’, which will see lights dimmed at 8pm and a flag raised on each ward to remind everyone about bedtime, the end of visiting hours for the day and the need to switch off electronic entertainment or use headphones.

“Additionally, each child will have a sign on their bed reminding staff and visitors of their usual bedtime and staff will use red torches to check on children at night rather than bright white lights.”

The project has already been piloted successfully in the children’s cancer ward and is now being rolled-out more widely across the children’s hospital.

Dr Hill added: “An ambitious programme is underway to train our staff in the importance of children’s sleep and we are already making great progress.

“We aim to take healthy sleep in hospital for young patients beyond a list of recommendations to fundamental culture change and have a transferable programme that can be adopted by children’s wards nationwide.”